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Association between vascular access failure and microparticles in hemodialysis patients
Jung-Hwa Ryu1, Su-Young Lim2, Dong-Ryeol Ryu1
1Division of Nephrology, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Background:
Vascular access failure, a major cause of morbidity in hemodialysis (HD) patients, occurs mainly at stenotic endothelium following an acute thrombotic event. Microparticles (MPs) are fragments derived from injured cell membrane and are closely associated with coagulation and vascular inflammatory responses.
Methods:
We investigated the relationship between levels of circulating MPs and vascular access patency in HD patients. A total of 82 HD patients and 28 healthy patients were enrolled. We used flow cytometry to measure endothelial MPs (EMPs) identified by CD31+CD42- or CD51+ and platelet-derived MPs (PMPs) identified by CD31+CD42+ in plasma samples of participants. Vascular access patency was defined as an interval from the time of access formation to the time of first access stenosis in each patient. MP counts were compared according to access patent duration.
Results:
The levels of EMP (both CD31+CD42- and CD51+) and CD31+CD42+PMP were significantly higher in patients than in healthy participants. Levels of CD31+CD42-EMP and CD31+CD42+PMP showed a positive correlation. In non-diabetic HD patients, CD31+CD42-EMPs and CD31+CD42+PMPs were more elevated in the shorter access survival group (access survival <1 year) than in the longer survival group (access survival ≥ 4 years).
Conclusion:
Elevated circulating EMP or PMP counts are influenced by end-stage renal disease and increased levels of EMP and PMP may be associated with vascular access failure in HD patients.
Insights
Elevated levels of endothelial microparticles (EMPs) and platelet-derived microparticles (PMPs) are linked to vascular access failure in hemodialysis patients. Higher microparticle counts may predict shorter access survival, impacting patient morbidity.
Area of Science:
- Nephrology
- Vascular Biology
- Hematology
Background:
- Vascular access failure is a significant complication for hemodialysis patients, often stemming from endothelial dysfunction and thrombosis.
- Microparticles (MPs) are cell membrane fragments linked to coagulation and inflammation, potentially indicating vascular injury.
Purpose of the Study:
- To investigate the association between circulating microparticle levels and vascular access patency in hemodialysis patients.
- To determine if specific microparticle types correlate with the duration of vascular access survival.
Main Methods:
- Flow cytometry was used to quantify endothelial microparticles (EMPs) and platelet-derived microparticles (PMPs) in plasma from 82 hemodialysis patients and 28 healthy controls.
- Vascular access patency was defined by the time to first access stenosis.
Main Results:
- Hemodialysis patients exhibited significantly higher levels of EMPs and PMPs compared to healthy individuals.
- Elevated EMP and PMP levels correlated positively.
- In non-diabetic patients, higher EMP and PMP counts were observed in those with shorter vascular access survival (<1 year).
Conclusions:
- End-stage renal disease influences circulating EMP and PMP levels.
- Increased EMP and PMP levels are potentially associated with vascular access failure in hemodialysis patients, highlighting their role as biomarkers.
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